Although patients with liver cirrhosis have historically been characterized by an increased propensity toward bleeding, recent evidence has introduced the concept of “rebalanced hemostasis.” Under these conditions, marked reductions occur in both procoagulant and anticoagulant factors, including substantial decreases in endogenous anticoagulants such as proteins C and S, as well as antithrombin III, potentially tipping the balance toward a prothrombotic state (24). The gene discussed is SERPINC1; the disease is cirrhosis of liver.